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What Is Euthanasia?

Euthanasia and assisted suicide have important distinctions

What Is Assisted Suicide?

How euthanasia differs, legal issues, who can choose it.

• Palliative Sedation

Euthanasia is when a doctor gives someone who is dying medication that will end their life.

Some use the terms assisted suicide , physician-assisted death , physician-assisted suicide , and mercy killing as synonyms for euthanasia. But legal and medical experts define these differently.

This article defines euthanasia, explains how it is distinguished from assisted suicide, and explores some of the legal limitations around this practice.

Assisted suicide is when severely or terminally ill people end their life with someone else’s help. There are many different ways that a person might help with a suicide, but assisted suicide is generally defined as follows:

• The person who wants to end their life has asked for help.
• The person understands what they are asking for will cause death.
• The person assisting knows what they’re doing. They intentionally help.
• The person assisting provides medication to the person who is ending their life.
• The person who wants to die takes the drugs themselves.

In physician-assisted suicide, a doctor provides medication to the person who wants to end their life. The doctor may also give instructions on how to take the medication so it will cause death. But the doctor does not inject the medication or even help the sick person swallow a drug.

Euthanasia is different than assisted suicide because, with euthanasia, the doctor actually administers the medication that causes death.

For example, a doctor may inject a dying person with drugs that will stop the heart.

Usually, euthanasia happens in a hospital or medical facility.

Types of Euthanasia

There are two types of euthanasia:

• Voluntary euthanasia: The sick person asks the doctor for help and the doctor agrees. Both act willingly.
• Involuntary euthanasia: Someone causes a sick person’s death without the sick person giving permission.

With physician-assisted suicide, the sick person takes the medication on their own. If a doctor, friend, family member, or anyone else administers the medication, it is considered euthanasia. 

Laws for assisted suicide and euthanasia vary by state and country.

Where Assisted Suicide Is Allowed

In the United States, physician-assisted suicide is allowed in:

• Washington D.C.

Several countries have also passed laws allowing doctors to assist with a suicide.

Many Americans seem to support laws allowing physician-assisted suicide. In a poll of 1,024 Americans, 72% of people said doctors should be able to help someone with an incurable disease end their life if they wish to.

If a doctor or anyone else actually gives the person the lethal medication, the act is considered euthanasia. That can be a crime even in areas that have assisted-suicide laws.

Where Euthanasia Is Allowed

Voluntary euthanasia is illegal in the United States and most parts of the world. Countries that do allow it include:

• The Netherlands

Involuntary euthanasia is illegal worldwide.

In places where voluntary euthanasia and physician-assisted suicide are legal, they’re only allowed if you have a terminal diagnosis. “Terminal” means you cannot be cured and doctors expect you to die from your illness.

In order to legally end your life, you may also be asked to show that you’re suffering severely from pain. Under the law, you may then be allowed to decide when and how you want to die.

People in many states and countries are calling for more laws that will allow them to choose when and how to end their lives. They call this " dying with dignity. " It's a topic that is hotly debated .

While a growing number of people think assisted suicide or voluntary euthanasia should be allowed, many others disagree. Those people say that it’s not morally or ethically right for doctors to help people die.

In 2019, the American Medical Association (AMA) Council on Ethical and Judicial Affairs (CEJA) sought to update their stance on assisted suicide. They revealed two divergent and equally valued opinions on the matter.

On the one hand, many doctors argue that “physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.” Doctors should work on making terminally ill patients comfortable, not helping them die.

On the other side, doctors argue that “a physician shall have compassion and respect for human dignity and rights.” By responding to the request of their patient to provide a lethal dose of medication that will relieve intractable pain and suffering of an incurable disease, a doctor is indeed expressing the highest level of care and compassion while supporting dignity at the end of life.

The AMA stands divided, concluding that physicians who legally participate in physician-assisted suicide are following their professional, ethical obligations as are the physicians who decline to participate. Most importantly, there should be full voluntary participation on the part of both patient and physician in these sacred decisions about how to approach end of life care.

Is Palliative Sedation Euthanasia?

No, nor is it physician-assisted suicide. Palliative sedation is when a doctor gives a terminal patient medication that will ease severe pain . This practice is sometimes more acceptable to people who disagree with assisted suicide or voluntary euthanasia.

The AMA Code of Medical Ethics says it’s acceptable for doctors to give sedatives to patients who are suffering, which are drugs that can relax the body and put you to sleep. In these instances, the patient may remain unconscious until their time of death. However, the drugs should never be used to intentionally cause a person’s death.

Sedation that makes a patient unconscious might be done as part of palliative care , which works to make a person as comfortable as possible when they are in the final stages before death.

Palliative sedation requires:

• Permission from the person who is sick or whoever is in charge of their healthcare decisions if the patient is unable to understand the situation and give consent
• A health care professional who can administer the drugs

Palliative sedatives are usually given in an IV that goes directly into the bloodstream or as a suppository. A suppository is medication that’s inserted into your rectum where it dissolves into the body.

Because the medication is fast-acting, sedatives must be given by a physician, nurse, or other health care professional.

People do sometimes die while under heavy sedation, but that is not the goal of the treatment. In these cases, it may not be clear whether someone died because of the medication or the illness.

Palliative sedation is not meant to end someone's life, but to heavily sedate them so they feel little to no pain in the time before they die naturally.

There are clear legal differences between euthanasia and assisted suicide. In euthanasia, a doctor performs an act that causes someone’s death. In assisted suicide, a doctor gives an ill person the lethal means they can then use to take their own life.

The arguments for or against ending a person’s life are never neat and clear.

It’s also important to understand that these are not the only ways to help a terminally ill person who is in severe pain. Palliative medicine and hospice care may offer other options for easing a loved one’s suffering.

A Word From Verywell

Whether or not to help someone die is an overwhelming question to consider. There are also legal issues to think about.

Ultimately, you must decide what is the right thing to do. If you have a loved one who is seriously ill, you should discuss all sides of the issue with them sooner rather than later. This way, you can make the best decisions when it’s time to think about their end-of-life care.

De Lima L, Woodruff R, Pettus K, et al. International Association for Hospice and Palliative Care position statement: Euthanasia and physician-assisted suicide . J Palliat Med. 2017;20(1):8-14. doi:10.1089/jpm.2016.0290

Goligher EC, Ely EW, Sulmasy DP, et al. Physician-assisted suicide and euthanasia in the ICU: A dialogue on core ethical issues . Crit Care Med. 2017;45(2):149-155. doi:10.1097/CCM.0000000000001818

ProCon.org. States with legal medical aid in dying (MAID) .

Gallup. Americans' strong support for euthanasia persists .

ProCon.org. Euthanasia & medical aid in dying (MAID) around the world .

Council on Ethical and Judicial Affairs. CEJA Report 2-A-19 . American Medical Association, 2022.

American Medical Association. AMA Code of Medical Ethics: Physician-assisted suicide .

American Medical Association. AMA Code of Medical Ethics: Sedation to unconsciousness in end-of-life care .

Erdek M. Pain medicine and palliative care as an alternative to euthanasia in end-of-life cancer care . Linacre Q . 2015;82(2):128-134. doi:10.1179/2050854915Y.0000000003

By Angela Morrow, RN Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse.

The Dilemma of Euthanasia Term Paper

What would you do if a friend of yours, a practicing doctor, sought your advice on whether he should let his chronically ill mother undergo euthanasia, otherwise known as ‘mercy killing’?

The ethical dilemma in this case is this: the patient wants the injection, the daughter in- law says she should wait; and the son says never. Besides, he is a doctor and as such, the only one who could make an informed decision. Physician author John Singer, who also had to make a decision on his mother, observes that “it becomes very difficult when that person is your mother (qtd in Preece 2002, p 30). The only difference, however, is that Singer thinks the money used to support a terminally sick person, who will eventually die regardless the effort, could be put into better use such as helping the poor.

The right to life guarantees every person the legal and moral protection against the termination of one’s life by another person through whatever means. Every human being has the right to live his/her life to the fullest, enjoying all the possible accompanying privileges. However, when the quality of live deteriorates beyond humanly tolerable conditions, the question arises whether continued living does the sufferer any good.

If his mother’s ailment subjects her to intense pain and suffering, so much so that life itself becomes intolerable, then wanting to die, and having that personal right to die and escape further suffering, theoretically, makes her decision credible. It is at this point, when it becomes a contention of professional ethics and moral considerations on the part of Jack and his wife on the one hand, and personal choice on the part of his mother, that we are left handing on the edge of a dilemma. What matters; is it the quality of life, in which case she should undergo euthanasia, or its sanctity, for which she will have to endure the pain until death decides otherwise?

How far can people really go in determining the fate of their lives? Why can’t his mother be left alone to make the ultimate decision of her life? Her son and daughter in-law could not be so thick hearted that they can’t pity their mother’s suffering. On the other hand, when people are inclined to make decisions that a sound mind would otherwise question and disapprove of, it automatically disqualifies such persons from making life decisions, even for themselves.

It happens so often that suicide survivors regret their actions, and later conclude that perhaps it was hardy foolishness, anger and short sightedness that made them to lose control of their mental judgment. In this light, the mother could be making unconsidered decisions out of pain. Her children could figure that she is in pain and as such, not acutely conscious of her decision. When she gets well, maybe, she will see that she was wrong to wish death upon herself. But will she, really?

To make a suitable decision, therefore, demands that we examine the condition of the patient and the chances she has of leading a quality life in future. And, in the case of Jack’s mother, two realities stare at us: her sickness is terminal, and secondly, she is at the very last phase of life. We should not depend on her judgment to end her life. However, at the right time, when everything else becomes hopeless, the doctors should switch off the machines and let her rest. It is here that morality fails to shed light on the problems we face in life, and euthanasia finds its value. Indeed, human wishes and desires notwithstanding, there is a point in life when man should accept his mortal nature.

The argument by Friedrich Nietzsche in relation to ethics is based on responsibility. But responsibility is tied to one’s ability to make promises, i.e. people become responsible for the promises they make. But then again, to make a promise he needs a memory to remind him of the promises lest he fails to honor it.

Nietzsche also argues that people act because of their autonomy to decide on their own the standards they will uphold, and the promises they will keep. Accordingly, guilt is not suffered in the event that either by omission or commission, an event that portends injustice comes to pass, because the person did not make any promise of acting in any respect. Nietzsche argues that a person is only responsible for what he promises to uphold.

His argument implies that individuals are held responsible if they promised to act in a certain way or committed themselves to a given course, and then failed or reneged on their promises. Consequently, one becomes guilty of theft if that person steals after promising that he/she will never steal. But now that he is independent, master of free will and has the right to recognize his own standards, he can decide that a little thieving and pinching of public coffers is right. Before he withdraws this promise, he is as innocent as an unconscious toddler of any wrong doing related to theft. In the case in question, nobody is bound by any responsibility for none has made any promise.

At the same time, Nieztsche is of the opinion that punishment is necessary to instill a sense of responsibility in people. He refers to the Germany history that ““we Germans certainly do not think of ourselves as an especially cruel and hard-hearted people, even less as particularly careless people who live only in the present…our penal code shows how much trouble it takes on this earth to breed a “People of Thinkers” (Nietzsche 2009).

In this regard, I find the arguments of John Mill and Immanuel Kant very relevant to the situation. The utilitarian views by John Stuart Mill on the justification of human actions consider life on a wider perspective i.e. the greatest good, while Immanuel Kant’s argument for good will emphasizes on acting on the best interests of others. On Liberty, Stuart Mill argues for what is good for the larger community. He differs from Hegel in that while he (Hegel) tried to justify human action on account of beliefs and universal principles, Mill focused on the consequences of those actions.

His central maxim is embedded in the utilitarian reasoning, which favors the idea of ‘goodness for all, or the greatest number of people.’ For instance, it would be right if a bus driver overran a child crossing the road, if avoiding him would have endangered the lives of several passengers. In addition, Mill posited that individuals have the freedom to seek that which satisfies them, to the extent in which it does not cause harm to others. Otherwise, the authority of society should intervene to protect those who would be affected by an individual’s actions.

In this sense then, a jihad on others is not permissible however justifiable in the Muslim understanding of the value of holy wars: this should be juxtaposed with the Roman church’s Crusades in the Middle East from around the 11 th century.

When the pursuit of the interests is overstretched as to hurts others, then even society’s authority should be limited (Mill, 1869, 134). For instance, we know that the war against terrorism portends the greatest good to all mankind. But how many innocent Afghan children must die as ‘collateral damage’ in the process? If hauling a few missiles in a crowded place would eliminate Taliban fugitives, is that justification enough to sacrifice innocent lives? Mill thinks otherwise. But Hegel would say that the absolute truth of the West, ‘defeating terrorism’ to protect innocent lives makes it right.

Mill argued that nobody has the right of correcting another person on what is good or right for that person (Mill, 1869, 138). This also recognizes the element of diversity in society, hence each individual is likely to think differently and desire different things. Mill says that “With respect to his own feelings and circumstances, the most ordinary man or woman has means of knowledge immeasurably surpassing those that can be possessed by anyone else” (Mill, 1869, 137).

Kantian ethics becomes relevant in this situation because it appeals to the will of the individual rather than the reasons given for or against it. Good will, he argues, is higher than even reason itself, because it is affected by neither motive nor consequences (Kant, 1998, 8). It appeals to the human capacity to make decisions out of one’s own volition, and the willingness of others to respect such decisions. It is good will that compels people to respect the wishes of others, for good will works for their best interests.

The Kantian ethics posit that an act is moral provided it is informed by reason and noble motive (Kant, 2001, 138). It departs from the utilitarian paradigm by emphasizing on the act itself rather than the consequences. It appeals to the human capacity to make rational decisions, which reflect universally acceptable rationales. In this case, none of the above actions would qualify as moral. By reason, you should not kill knowingly even if the worth of the kid’s life pales against sixty adult passengers.

The other tenet of Kantian thought is that emotions and passion are not grounds for doing a moral act. Accordingly, it is not moral to donate to the Red Cross because you were moved by TV pictures of emaciated and starving children in Darfur. But it would be right if giving out is a humanly act that by reason, all people of means should pursue.. As Kant puts it, “We have to rely on ourselves: we become our own author….our own authority, and we have to use and appeal to our capacity to reason and think” (Kant, 2001, 139).

Kant, I., Gregor, M. J. (1998). Groundwork of the metaphysics of morals . London: Cambridge University Press.

Kant I. (2001) Lectures on ethics . London: Cambridge University Press.

Mill, J. S. (1869). On Liberty . Longmans, Green, Reader, and Dyer, New York.

Nietzsche F. (2009). “Good and Evil, Good and Bad.” On the Genealogy of Morals .

Preece, G. (2002). Rethinking Peter Singer: a Christian Critique. New York : InterVersity Press.

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Euthanasia Term Paper

Term paper on euthanasia:.

Euthanasia is the practice of the ending of life of a patient, who suffers from the disease which can not be cured and causes him enormous pain. The purpose of euthanasia is to bring relief to the patient and release him from suffering. The term ‘euthanasia’ is used in completely different meanings: acceleration of the death of a patient who suffers from incurable pain; the ending of life of the ‘odd’ people; care of the close people; opportunity for a person to die on their own volition.

Euthanasia is also the practice of humane putting animals to death, including laboratory and homeless animals. Euthanasia has always been a controversial topic, no wonder it is banned in many countries of the world, especially where religion and traditions play the greater role.

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There are two main types of euthanasia: passive and active. Passive euthanasia is the ending of the therapy for the patient by doctors. Doctors simply stop supporting the life of a patient who can not be cured and let him die himself. Active euthanasia is a bit different phenomenon, because doctors introduce the medicine or substances into the patient’s body, which causes his death rapidly and painlessly. Suicide is also understood as euthanasia, when the person asks medicine from a doctor with the purpose to end her life. Moreover, there are two more serious types of euthanasia: voluntary and non-voluntary. Voluntary euthanasia is practised on the basis of the patient’s permission given in the sober condition and signed by a lawyer. Non-voluntary euthanasia is practised on the basis of the permission of the relatives of the patient, who stays in the condition of unconsciousness.

The problem of euthanasia is very delicate and there are many opponents to this practice., no wonder many countries of the world forbid euthanasia calling it an inhumane and unnatural procedure. A student who is asked to complete a term paper on euthanasia should treat the assignment with responsibility and research the topic from all sides. One should explain the term of euthanasia, provide the reader with the attitude of different groups of people towards it, present the methodology and the purposes of euthanasia and prove it has certain advantages and on the contrary – disadvantages and summarize the topic professionally.

Sometimes the process of term paper writing becomes a problem and students require a good free example euthanasia term paper outline to understand how to organize the writing process correctly and how a good term paper should look like. With the professional assistance of the Internet every student can read a free sample euthanasia term paper introduction and catch the idea of the correct structure and format of the paper and the logical data analysis of the topic.

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🖋 best way to write a great college term paper, euthanasia term paper.

In partial fulfillment of ‘ Your the college term paper Degree’ Writing Citations and references as per the specifications given by the professor Presenting the Paper Write Term Papers – Free Sample Term Papers Write Term Papers – Free Sample Term Papers Learn How to Write College Term Papers Technical details of war ting A-plus College term papers Write Term Papers . Com – Best custom written online term papers – Buy Custom Term Papers @ $7. 5 Submitted by – Rosa Bowels delivery of college term papers emergency not delivered on time Timely please do not copy custom college term papers Philosophy college term papers Business ERM papers – Advertising term papers social science term papers law term papers Science term papers 7 pages – 2200 words apron Citations – PAP This is sample term paper text in back ground is only for collecting as much data on Doing the research on title page – Scanning Research Resources farcically use and will not the topic to attack all point of views Organizing the term paper -appear on your term paper Writing the college term paper Citations and references as per the specifications given by the professor Presenting Feel free to see our free sample college term papers. Now you can buy custom allege term papers at Just $7. 95 @ Write Term Papers. Buy Custom term papers. Need help in writing college term papers contact write term papers . Com . Any other help regarding sale of custom college term papers contact writetermpapers@gmail. Com term papers for free. Buy custom college term papers from Write Term Papers Is Euthanasia Ethical Euthanasia, Just like abortion the word Euthanasia has violent reactions from people.

Not literally, but emotionally, the reactions are violent and they are aggressive, at times even the most docile people have ever y strong views about euthanasia. To start, all I had like to say is that “Don’t be selfish, don’t make another person suffer for your joy’. Do not make your loved one go through pain. The Joy of having someone with you is lesser than the pain that they go through. If you love someone, done give them pain, free them. I do not advocate Euthanasia for people who have a chance to recover, but I advocate it for people who cannot recover. There are examples from the Oscar winning movie Million Dollar Baby and even the Terrier Savior case.

There are many points of view, people feel we cannot take away what we have not given, UT another line of thought is that if the family decides (and hopefully their decision is not based on some will that makes them millionaires after this person goes) then from the Greek word e for good and thanks which means death and originally referred to intentional mercy killing. Nevertheless, the word euthanasia has acquired a more complex meaning in modern times. Proponents of euthanasia believe that a dying patient has the right to end their suffering and leave the world in a dignified manner. Those who contest euthanasia believe that man does not have the right to end another person’s life no matter what pain they endure. Euthanasia is one of the most important public policy issues being debated today. The outcome of debate will profoundly affect family relationships, interaction between doctors and Patti nuts, and concepts of basic morality. The Feel free to see our free sample college term papers.

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Now you can buy custom college term papers at Just $7. 95 @ Write Term Papers. Buy Custom term papers. Need help in writing college term papers contact write term papers . Com . Any other help regarding sale of custom college term papers contact word euthanasia has acquired a complex meaning in modern times. There are several types of euthanasia and one must define them in order to avoid confusion. Passive euthanasia is the process of hastening the death of a person by withdrawing some forms of support and letting nature take its course. Such an act would include removing life -support equipment, stopping medical procedures, stopping food and water and allowing the person to die.

Active euthanasia involves causing the death of a person through a direct act The simple principle of life is that many of us derive our Joy from our loved ones and it’s the Joy of having that person around, that makes s decide to let this person live with a disease, but their pain and suffering is more than our Joy and so we must let go. So pulling a life support machine is not the easiest decision to make for another person’s life. There are a few countries in the world where euthanasia is legal and people are allowed to make that c hospice. The debate is on in many other countries and people are divided on basis of religion or self-righteousness.

The samurai tradition gives a good analogy ” he samurai ritual of espouse comes very close T to euthanasia indeed – an assistant would behead the suicide after the suicide had fatally stabbed themselves in order to bring death swiftly and reduce the time the suicide was in pain. The samurai motivation for suicide was similar to that of the person seeking euthanasia: either they had lost a battle and would be killed by their enemies (the analogy is that the patient has lost their battle against the disease, and it will kill them) or they had been so badly wounded that they could no longer be useful members of society (the patient could be in a similar position). In line with Buddhist thinking, the espouse ritual laid great emphasis on the suicide avian a peaceful mind during the action. ” The Buddhist generally are no very clear on euthanasia, they feel that ” Death is a transition.

The deceased peers on will be reborn too new life, whose quality will be the result of their karma. This produces two problems. We do not know what the next life is going to be like. If the next life is going to be even worse than the life that the sick person is presently enduring it would clearly be wrong on a utilitarian basis to permit euthanasia, as that shortens the present bad state of affairs in favor of an even worse one. The second problem is hat shortening life interferes with the working out of karma, and alters the karmic balance resulting from the shortened life. Another difficulty comes if we look at voluntary euthanasia as a form of suicide.

The Buddha himself showed tolerance of suicide by monks in two cases. The Japanese Buddhist tradition includes many stories of suicide by monks, and suicide was used as a political weapon by Buddhist monks during the Vietnam War. However, these were monks, and that makes a difference. In Buddhism, the way life ends has a profound impact on the way the new life will begin. Therefore, a person’s state of mind at the time of death is important – their thoughts should be selfless and enlightened, free of anger, hate or fear. This suggests that suicide (and so euthanasia) is only approved for people who have achieved enlightenment NT and that the rest of us should avoid it. ” An article from Lifelikeness. Mom puts a broader perspective on Switzerland adoption of euthanasia and the situation in Netherlands and Belgium. “Lausanne University hospital, Switzerland has decided to permit assisted suicides starting from January 1, 2006. Assisted suicide has always been considered a form of active euthanasia. In addition to Lausanne, other leading Swiss hospitals are now actively discussing permitting the procedure. However, Swiss law initial Ill did not allow doctors to kill their patients the practice of euthanasia has been gradually extended from private groups into the public health systems. According to Doctors for Life consistent pattern. Assisted suicide is presented to the public as a last resort necessary to alleviate human suffering.

Once this becomes acceptable to the public, says UDF, the categories of people deemed expendable steadily expands to include those perceived to have a diminished value to society or to themselves. In the Netherlands, doctors have been allowed to practice active euthanasia since 1973. While Dutch death regulations initially required that euthanasia be strictly limited to the sickest patients, it has been steadily redefined with the protective guidelines gradually eroded. As a result, Dutch doctors now legally kill the terminally ill, the chronically ill, disabled people and depressed people, on demand, Doctors for Life reports. Furthermore, repeated studies sponsored by the Dutch government show that a significant number of patients are killed by their doctors every year as a result of involuntary euthanasia.

Consequently, says UDF, “eugenic infanticide has now become common in the Netherlands (even though babies cannot ask to be killed). ” According to a 1997 study published in the British medical Journal The Lancet, approximately 8 percent of all Dutch infant deaths result from lethal injections. An alarming 45 percent of entomologists and 31 percent of Feel free to see our free sample college term papers. Now you can buy custom college term papers at Just $7. 95 @ Write Term Papers. Buy Custom term papers. Need help in writing college term papers contact write term papers . Com . Any other help regarding sale of custom college term papers contact writetermpapers@gmail. Com pediatricians who responded to Lancet surveys had killed babies. A more severe slide down this slippery slope has been well documented in Belgium with euthanasia advocates actively fighting to not only expand the categories o killable people but to also force health care f workers with moral objections to participate in assisted suicides against their consciences. ” The scary part is that people are being killed involuntarily! As much as I support euthanasia, I do not think that a doctor should decide when to end life, that decision must be made by the person or his immediate Emily. Many people I know feel that only the person should decide if he or she wants to end their life, but I feel that they may not always be in a position to decide, the disease itself or a coma etc can prevent people from deciding to end or continue life.

Here is another line of thought by Emmanuel Kant on Suicide “Firstly, under the head of necessary duty to oneself: He who contemplates suicide should ask himself whether his action can be consistent with the idea of humanity as an end in itself. If he destroys himself in order to escape from painful circumstances, he uses a person rely as a mean to maintain a tolerable condition up to the end of life. However, a man is not a thing, that is to say, something that can be used merely as means, but must in all his actions be always considered as an end in him. I cannot, therefore, dispose in any way of a man in my own person so as to mutilate him, to damage or kill him. (It belongs to ethics proper to define this principle more precisely, so as to preserve myself, as to exposing my life to danger with a view to preserve it, etc. This question is therefore omitted here. ” The above is taken from Emmanuel Cant’s Fundamental Principles of the Metaphysics f Morals as translated by Thomas Smiling Abbott. Kant does not directly touch the topic of euthanasia, but he seems to suggest that as much as possible one must try to preserve life. However, the surprising part is that Euthanasia was allowed in per – war Germany under Hitler- you might say that Hitler was a killer, but there are some startling articles around Euthanasia in Germany during Hitter’s time. In 1920 was published a book titled The Permission to Destroy Life Unworthy of Life, by Alfred Hooch, M. D. , a professor of psychiatry at the University of Firebug, and Karl Binding, professor of law from the University of Leipzig.

T hey argued in their book that patients who ask for “death assistance” should, under very carefully controlled conditions, be able to obtain it from a physician. The conditions were spelled out, and included the submission of the request to a panel of three experts, the right of the patient to withdraw his request at any time, and the legal protection of the physicians who would help him terminate his life. Binding and Hooch explained how death assistance was congruent with the highest medical ethics and was essentially a compassionate solution to a painful problem. Death assistance, according to the authors, was not to be limited to those who were able or even willing to ask for it.

They would have such mercy extended as well to “empty shells of human beings ” such as those with brain damage, some psychiatric conditions, and mental retardation, if by scientific criteria the “impossibility of improvement of a mentally dead person” could be proven. The benefits to society would be great, they said, as money previously devoted to the care of “meaningless life” would be channeled to those who most needed it, the socially and physically fit. Germans needed only to earn to evaluate the relative value of life in different individuals. An opinion poll conducted in 1920 revealed that 73% of the parents and guardians of severely disabled children surveyed would approve of allowing physicians to end the lives of disabled children such as their own. Newspapers, Journal articles, and movies joined in shaping the opinion of the German public.

The Ministry of Justice described the proposal as one that would make it “possible for physicians to end the tortures of incurable patients, upon request, in the interests of true humanity” (reported in the N. Y. Times, 10/8/33, p. 1, cool. 2). Moreover, the savings would redound to the German people if money was no longer thrown away on the disabled, the incurable, and “those on the threshold of old age. ” A 1936 novel written by Helmut Anger, M. D. , further assisted the German people in accepting the unthinkable. Dry. Anger told the story of a physician whose wife was disabled by multiple sclerosis. She asks him to help her die, and he complies. At his trial, he pleads with the Jurors to understand his honorable motive: “Would you, if you were a cripple, want to vegetate forever? ” The Jury acquits him in the novel.

The book was subsequently made into a movie that, according to research by the AS Security Service, was “favorably received and discussed,” even though some Germans were concerned about possible abuses. With the public now assenting, the question turned from “whether” to “by whom” and “under what circumstances. ” The first known case of the application of this now- acceptable proposal concerned “Baby Nearer. ” The child’s father requested of Adolph Hitler himself that his son be allowed death because he was blind, retarded, and missing an arm and a leg. Surely, in his condition, he would be better off dead. Hitler turned the case over to his personal physician, Karl Brandt, and in 1938, the request was granted.

Over the next few months, a committee set out to establish practical means by which such “mercy deaths” could be granted to other children who had no prospect for meaningful life. The hospital at Gelling-Hear, under the direction o Hermann Funereally, M. D. , slowly f starved many of the disabled children in its care until they died of “natural causes. ” Other institutions followed suit, some depriving its small patients of heat rather than food. Medical personnel who were uncomfortable with what they were asked to do were told this was not killing: they were simply set up Huntresses (starvation houses) for the elderly. By the end of 1941, euthanasia was simply “normal hospital routine. ” In the meantime, no law had been passed permitting euthanasia.

Rather, at the end of 1939, Hitler signed this letter: “Rescheduled Boulder and Dry. Med. Brandt are responsibly commissioned to extend the authority of physicians to be designated by name so that a mercy death may be granted to patients who, according to human Judgment, are incurably ill according to he most critical evaluation of the state of their disease. ” Not many of us would expect Hitler to pass a Jurisdiction like this, but it seems that he genuinely wanted to help people by allowing euthanasia and the establishment of a panel and passing on the case of Baby Nearer to his personal physician only add credibility to Hitter’s actions on euthanasia.

In the end I had like to repeat, t is Joyful to see the ones we love, but true love would be in feeling their pain and letting them go, for the Joy of seeing them around is not more the pain that they are going through.

Related Term Papers:

• Term Paper on Right to Die
• School Papers
• Biomedical Ethics – Term Paper
• Euthanasia – Term Paper

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Euthanasia and physician-assisted suicide: a systematic review of medical students’ attitudes in the last 10 years

Alejandro gutierrez-castillo.

1 Researcher, School of Medicine, Monterrey Institute of Technology and Higher Education, Nuevo León México, Mexico.

Javier Gutierrez-Castillo

Francisco guadarrama-conzuelo, amado jimenez-ruiz.

2 Neurology Resident, Department of Neurology, National Institute of Medical Science and Nutrition Salvador Zubirán, Ciudad de México, México.

Jose Luis Ruiz-Sandoval

3 Professor, Department of Neurology, Civil Hospital of Guadalajara “Fray Antonio Alcalde”, Jalisco, México.

This study aimed at examining the approval rate of the medical students’ regarding active euthanasia, passive euthanasia, and physician-assisted-suicide over the last ten years. To do so, the arguments and variables affecting students’ choices were examined and a systematic review was conducted, using PubMed and Web of Science databases, including articles from January 2009 to December 2018.

From 135 identified articles, 13 met the inclusion criteria. The highest acceptance rates for euthanasia and physician-assisted suicide were from European countries. The most common arguments supporting euthanasia and physician-assisted suicide were the followings: ( i ) patient’s autonomy (n = 6), ( ii ) relief of suffering (n = 4), and ( ii ) the thought that terminally-ill patients are additional burden (n = 2). The most common arguments against euthanasia were as follows: ( i ) religious and personal beliefs (n = 4), ( ii ) the “slippery slope” argument and the risk of abuse (n = 4), and ( iii ) the physician’s role in preserving life (n = 2). Religion (n = 7), religiosity (n = 5), and the attributes of the medical school of origin (n = 3) were the most significant variables to influence the students’ attitude. However, age, previous academic experience, family income, and place of residence had no significant impact.

Medical students' opinions on euthanasia and physician-assisted suicide should be appropriately addressed and evaluated because their moral compass, under the influence of such opinions, will guide them in solving future ethical and therapeutic dilemmas in the medical field.

Introduction

Death by itself is not part of an ethical dilemma, as all lives are bound to end since the moment of conception, and human beings confront death through their personal beliefs, religion, and cultural context. Regardless of the natural and unavoidable causes of death, debate over death focuses on how to control it as well as on who and how should perform the death-related practices in medical field. The important role of physicians in this debate is that they are often both the judge and the executor of such practices ( 1 ). Several physicians believe that the idea of promoting death is against Hippocratic Oath and their primary role as healer, while others may reject the idea based on their moral or religious values ( 1 ).

The issues on control over death can be divided into two broad categories: euthanasia and physician-assisted suicide (PAS). Euthanasia is further divided into active euthanasia (AE) or passive euthanasia (PE), according to the role that the physician plays in the process. The term PE is no longer used in some countries, and the term Therapy Withdrawal (TW) is replaced as the physician’s role is limited to suspending treatment or stopping additional measures that artificially prolong life. In TW, the physician acts as a mere observer while the disease advances and ends the patient’s life. However, in AE, the physician operatively engages in ending patient's life by administering a toxic substance that accelerates death ( 2 ). In PAS, the physician intentionally helps the patient to commit suicide by providing drugs for their self-administration at the patient’s competent and voluntary request ( 3 ). The differences among aforementioned approaches have implications that surpass their moral approval, as the medical actions involved in these approaches are regulated by law. According to the American Medical Association (AMA), AE and PAS are in conflict with physicians’ healing role. Furthermore, their management are quite challenging, if not completely impossible, and they entail grave risks to the society ( 4 ). However, PE, described as withdrawal or withholding life-sustaining treatment, is ethically acceptable for a patient capable of decision-making, and if an intervention is not expected to achieve the patients’ goals for care or desired quality of life ( 4 ).

The contributions of this study are as follows: ( i ) quantitative assessment of medical students’ approval rate for AE, PE and PAS over the last ten years, ( ii ) analysis of the most common arguments validating such practices, and ( iii ) evaluation of the variables that can influence a personal position on the topic. This study aimed at answering the following questions: What is the percentage of euthanasia or PAE approval among medical students? What are the most common arguments associated with the approval or rejection of euthanasia or PAE? What are the variables affecting the approval or rejection of euthanasia and PAE?

This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) ( 5 ) ( Figure 1 ).

PRISMA flowchart

The literature searches in April 2019, included articles published between January 2009 and December 2018, and focused on PubMed and Web of Science as the primary electronic databases. The databases were searched using the following search strings: (medical students) AND (euthanasia OR Physician-assisted suicide).

Our review focused on original cross-sectional descriptive studies in English whose main population, or part of it, was composed of medical students and quantified their personal views regarding the legalization or practice of PAS or euthanasia.

Only original descriptive articles that quantitatively addressed the first focused question in the last ten years were included. The excluded cases were the followings: ( i ) Review articles, book chapters, conference papers, and letters to the editor; ( ii ) Non-neutral reports, where the authors expressed their views or stated an opinion on the topic; ( iii ) Articles whose main population consisted of physicians, nurses, or any group other than undergraduate medical students; ( iv ) Articles for which the complete text could not be found online; and, ( v ) Articles written in languages other than English.

Records were initially screened according to the titles and abstracts. Relevant abstracts and articles without an abstract were selected for full-text review. Articles selected in the first screening were carefully read and analyzed to determine whether they addressed the first focused question and whether they fulfilled the inclusion criteria. Further analyses were made to determine if they described any argument or variable that could persuade medical students to take a positive or negative side.

A total of 135 articles were identified after the database search (63 in PubMed and 72 in Web of Science); 97 non-duplicate documents were screened by the title and abstract. From the 25 articles eligible for full-text review, 13 fulfilled the inclusion criteria and were selected for further analysis ( 6 - 18 ). Reasons for exclusion of 12 remaining articles were as follows: ( i ) use of a language other than English (n = 2); ( ii ) absence of a full-text version online (n = 3); ( iii ) inclusion of a study population different than undergraduate medical students (n =3); and, ( iv ) failure to address the first focused question (n = 4).

From the 13 selected articles, seven ( 6 - 12 ) were published between 2014 and 2018 and six ( 13 - 18 ) were published between 2009 and 2013. Two studies were from Africa ( 7 , 9 ), four were from America ( 6 , 8 , 12 , 14 ), one was from Asia ( 15 ), and six were from Europe ( 10 , 11 , 13 , 16 - 18 ). The countries involved included Austria (n = 1) ( 18 ), Belgium (n = 1) ( 11 ), Brazil (n = 1) ( 12 ), Canada (n = 1) ( 14 ), Germany (n = 1) ( 10 ), Greece (n = 1) ( 18 ), Mexico (n = 2) ( 6 , 14 ), Pakistan (n = 1) ( 15 ), Poland (n = 2) ( 13 , 16 ), and South Africa (n = 2) ( 7 , 9 ).

Eight articles addressed the approval rate of medical students regarding legalization of AE, PE or PAS ( 7 - 9 , 11 , 13 , 15 - 17 ); ten stated a positive attitude toward AE exclusively ( 6 - 12 , 15 , 17 , 18 ); six addressed acceptance of PE ( 6 , 9 , 10 , 12 , 14 , 18 ); and, six addressed acceptance of PAS ( 7 , 8 , 10 , 14 , 15 , 18 ). Two articles addressed the students’ personal views on AE, PE or PAS, whether exclusively or conjunctively ( 13 , 16 ). The results are summarized in Table 1 .

Percentage of approval for AE, PE, and PAS, as well as the legalization of euthanasia or PAS.

Out of eight articles that addressed the positive views on legalization of the procedures, the lowest acceptance rate was 26% ( 13 ) and the highest 97% ( 11 ). The lowest and highest acceptance rates were as follows: ( i ) 14.2% ( 15 ) and 52% ( 18 ) for AE, ( ii ) 45.7% ( 12 ) and 83.3% ( 10 ) for PE, and ( iii ) 32.8% ( 15 ) and 69.7% ( 18 ) for PAS. The highest acceptance rates in the four scenarios were observed among students in European countries ( 10 - 12 , 15 ), while the lowest acceptance rates were related to Pakistan ( 15 ) and Brazil ( 12 ).

Eight articles ( 6 - 8 , 11 , 15 - 18 ) were related to second main question addressing students’ arguments for or against the practice of AE, PE or PAS. The most common arguments supporting AE, PE or PAS practice were as follows: ( i ) patients’ autonomy (n = 6) ( 6 - 8 , 11 , 16 , 17 ); ( ii ) relief of suffering or beneficence (n = 4) ( 7 , 11 , 16 , 17 ); and, ( iii ) the thought that terminally-ill patients are additional burden (n = 2) ( 11 , 18 ). Less relevant arguments included the followings: ( i ) legality of the procedure ( 6 ); ( ii ) educational or clinical experience ( 8 ); and, ( iii ) quality of life or life expectancy ( 18 ). The most common arguments against AE, PE or PAS were the followings: ( i ) religious or personal beliefs (n = 4) ( 7 , 8 , 15 , 18 ); and, ( ii ) “slippery slope” argument or risk of abuse (n = 4) ( 7 , 8 , 16 , 18 ); and, ( iii ) physicians’ responsibility to preserve life ( 7 , 18 ). The results are summarized in Table 2 .

Students’ arguments in favor or against the practice of euthanasia or PAS

Regarding the third focused question, 11 articles ( 6 - 9 , 11 , 12 , 14 - 18 ) highlighted variables that could cause the medical students to approve or disapprove AE, PE or PAS practices. Religion was the most significant variable that had a negative impact (n = 7) ( 6 - 8 , 11 , 12 , 14 , 16 ), followed by religiosity (n = 5) ( 6 , 12 , 14 , 15 , 18 ) as the second most significant variable. Moreover, university of origin for the medical students (n = 3) ( 12 , 14 , 16 ) and previous experience with euthanasia or palliative sedation in a relative (n = 1) ( 11 ) were other named variables. Non-significant variables included the followings: ( i ) age (n = 3) ( 6 , 12 , 17 ); ( ii ) previous academic experience regarding end-of-life decisions (n = 2) ( 11 , 16 ); ( iii ) family income (n = 1) ( 12 ); and, ( iv ) size or place of residence (n = 1) ( 16 ). Variable of gender in influencing the students’ opinions showed mixed results: significant ( 6 , 16 ) and non-significant ( 11 , 12 , 14 , 17 , 18 ). Similarly, for variable of medical students’ current academic year, three studies considered it to be significant ( 9 , 15 , 17 ) and one study reported it as irrelevant ( 6 ). The summarized results are shown in Table 3 .

Significant variables that affect the posture of medical students towards euthanasia or PAS

Despite the great diversity of opinions regarding AE, PE and PAS, the percentage of approval for AE was lower than those of PE or PAS in all analyzed scenarios ( 6 - 18 ). Regarding AE approval, the study of Kontaxakis et al. was the only one that reported an acceptance percentage higher than 50%, under special circumstances ( 18 ). If these results are compared to those of other groups, such as general population ( 19 ) or post-graduate students ( 11 ), the approval rate is usually higher than 50%. In contrast, physicians tend to show a negative attitude toward the topic ( 19 , 20 ). The relevance of clinical experience, as a variable that could influence the acceptance of euthanasia or PAS, was discussed by Marais et al. ( 9 ) and Hassan et al. ( 15 ), who reported different results depending on whether the students were at preclinical level (without active experience with patients) or on clinical rotations. Marais et al. stated that higher clinical-level correlated to medical students’ greater empathy towards patients and respect for their autonomy. This correlation was demonstrated by a 20% difference in acceptance rate for AE between preclinical and clinical students, which dropped to 10% when they were asked if they will perform an assisted-dying procedure ( 9 ). Hassan et al. found lower acceptance rate for euthanasia or PAS among senior medical students; the attitude toward euthanasia, however, split to 50% against and 50% undecided, highlighting a higher percentage of indecision among seniors than freshmen ( 15 ). Seniors stated that through clinical exposure, medical students become more aware that some diseases are incurable ( 15 ). However, a 2018 study by the authors of article ( 6 ) did not identify academic rank as a variable that could influence medical students’ attitude toward this topic. That study focused only on preclinical students in the first three years of medical school, justifying the uniformity of opinions and highlighting that exposure to patients affected medical students’ views regardless of their academic school year.

Until now, AE has been legalized in Belgium ( 11 ), the Netherlands ( 19 ), Luxemburg ( 19 ), Colombia ( 21 ), Uruguay ( 21 ), and Canada ( 8 ); Three countries where AE is legal are European ( 11 , 19 ), which justify that why the majority of the papers that met the present study’s inclusion criteria were published in this continent where the debate is open. In Belgium, the only country included in this study where AE is currently legalized, Roelans et al. reported that the approval percentage of the legalization of euthanasia to be 97% ( 11 ); a real legal environment, along with personal or professional experience in scenarios of assisted death, can create more favorable attitude among medical students ( 11 ). In Canada, another country where these practices are legalized, the study by Bator et al. was performed a year before the Canadian laws’ modification to abolish the penalization of euthanasia ( 8 ). These political discussions may affect medical students’ attitude toward acceptance.

Religion is defined as a moral institution with a unified system of values, beliefs and practices related to what is considered sacred ( 22 - 23 ). Religion is one of the most common variables mentioned by researchers to influence medical students’ views on euthanasia ( 6 - 8 , 11 , 12 , 14 - 16 , 18 ). Moreover, religion affects several other areas of medicine, such as adherence to treatment or the decision-making process in high-risk procedures ( 22 ). In seven studies that described religion as a relevant variable, five found Catholicism to be the most frequently self-reported religion ( 6 , 11 , 12 , 14 , 16 ), and less frequently ones were Christianity ( 7 ) and Islam ( 15 ). Conversely, the medical students who considered themselves atheists or those who did not actively practice any religion tended to have a more positive view towards AE, PE, and PAS for both patients and themselves ( 8 , 11 , 12 , 14 - 16 , 18 ). Different, sometimes conflicting views can be observed among various religions. In 2007, Sprung et al. studied the attitude of physicians towards PE; Catholics, Protestants and those with no religious affiliation compared to Jews, Greek Orthodoxies or Muslims had higher acceptance rate for therapy withdrawal ( 23 ). According to the Roman Catholic religion, practitioners are not obligated to ward off death at all costs, but they should not deliberately intervene to accelerate this process ( 24 ). The principle of “sanctity of life” categorizes life as a basic value as it establishes a direct relationship with God, and condemns any intervention that seeks to end this relationship ( 24 ). This principle could explain a more negative attitude toward AE and a mildly open posture toward PE. Studies that described a majority of the Catholic population and addressed the attitude of PE had acceptance rate higher than 50%, except one study from Poland ( 16 ). Leppert et al. did not separate the opinions in favor of or against AE, PE, or PAS, and considered that the students’ view could be influenced by the statements of the last Polish Pope, John Paul II ( 16 ). Regarding Islam, negative attitude is generally stated toward the topic ( 7 , 15 , 23 ). The Quran forbids self-harm and consenting to end life, which can be related to terminally-ill patients consenting to euthanasia ( 25 ). In Islam, death is not the final destination, and therefore a believer should keep facing difficulties despite suffering to stay alive ( 25 ). However, the concept of religion has to be differentiated from religiosity or religiousness, referring to the influence of religion on daily life and intrinsic values. A positive experience with religion, mainly described as a growing spirituality or closeness to God, empowers patients to undertake greater risks in their treatments ( 22 ). Regarding euthanasia, the greater the religiosity, the more opposition towards euthanasia ( 6 , 15 ). This association is in line with our previous study’s findings, where the participants who were described as strong believers showed a predominant negative view towards AE and PAS as well as inflexibility to change their original position in different scenarios ( 6 ). Similarly, Hassan et al. reported the lowest acceptance rate for AE, in a study involving predominately Muslim participants, which 17% of them identified themselves as very religious ( 15 ).

The main arguments on euthanasia are related to the bioethical principles. Autonomy, the most common argument stated by the medical students to support this practice ( 6 - 8 , 11 , 16 , 17 ), derives from the Greek auto (self) and nomos (rule) and refers to the individuals’ ability to make independent choices about their treatment ( 7 ). However, the state of autonomy in relation to euthanasia varies depending on whether autonomy is considered an intrinsic or moral value. In the former, patients would have free will in decision-making about their life or death ( 26 ), and in the latter —according to the Kantian perspective—death threatens autonomy by eliminating the individual who would otherwise exercise autonomy ( 27 ). Another argument to support euthanasia is relief from suffering, based on the principle of beneficence, as it considers the induction of death as a better alternative to avoid unnecessary suffering ( 28 ). The opponents of euthanasia argue that the elimination of suffering by death may not be the best alternative considering the followings: ( i ) increasing interest and research on palliative care and ( ii ) management of patients’ psychiatric conditions (e.g., depression), which may adequately relieve their suffering ( 28 , 29 ). The most common arguments against these practices were as follows: ( i ) personal and religious beliefs ( 7 , 8 , 15 , 18 ); ( ii ) risk of abuse, sometimes referred to as the “slippery slope” argument ( 7 , 8 , 16 , 18 ); and, ( iii ) the physicians’ role in preserving life ( 7 , 18 ). According to the argument of the “slippery slope”, if specific types of actions receive permission, then society will be coerced in permitting further morally wrong actions ( 30 , 31 ). As a classic example of this argument, in the Netherlands, where initially euthanasia was only approved for terminally-patients, the criteria were later expanded to allow euthanasia for chronically-ill patients and those suffering from severe psychiatric conditions. Subsequently, euthanasia was legally allowed for incompetent patients, including children ( 31 ). Opponents of the “slippery slope” argument state that for euthanasia to be considered as part of the risk of abuse argument, it must initially be condemned as morally wrong, an argument that in their opinion is dependent merely on personal experience ( 31 ). The final argument against euthanasia is the Hippocratic Oath’s view of the physicians’ role as healers. The Hippocratic Oath was first proclaimed in 400 BC and established one of the earliest codes of ethics for the medical profession ( 32 ). Because of its tradition and relevance, it is still frequently taken by medical students during their training or upon its completion. One of its lines states that physicians will not give poison to anyone though asked to do so, nor they would suggest such a plan ( 6 ), a line that contradicts modern-day views of euthanasia. This presumptive allegiance to the Hippocratic Oath may explain why students from newer, urban, public, and bigger universities usually have a more positive attitude towards euthanasia and PAS than students from older schools with more traditional values ( 12 , 14 , 16 ).

The relevance of understanding the medical students’ attitudes towards euthanasia and PAS lies not only in their values as present-time insights, but also as input data to generate strategies that optimize their education and address future medical dilemmas. Even though medical students usually have sufficient knowledge about euthanasia ( 15 ), they lack understanding of end-of-life care. Eyigör stated that most medical students believe that they have not received a complete education on palliative care or training on communication skills regarding palliative-care patients ( 33 ). A better understanding of end-of-life care, including euthanasia and PAS, for medical students, is essential, even if these practices are not currently legalized in their countries as related debates on the topic are not expected to end shortly.

A major limitation of this study was the use of non-standardized questionnaires to research the main focused questions, as they provide varied responses that are difficult to categorize and analyze adequately. Even if a students’ view on euthanasia or PAS is markedly positive or negative, the format of the questionnaire may not accurately address the real answer. Moreover, questions asked directly may obtain different answers than those asked indirectly; questions with clinical case scenarios or with only binary true or false answers could further alter the results. Another limitation was the use of only two electronic databases, which could narrow results. This limitation could also limit the number of countries included in the study, which may prevent the global perspective from being reflected.

Seeking a global perspective from medical students over a particular course and then describing that perspective is complex. This complexity is not only due to the great diversity of opinions, but also due to the geographical, social, cultural, and temporal context influencing their decisions. This study aimed to objectively describe the medical students’ attitude towards AE, PE, and PAS practices as well as to analyze the variables and arguments surrounding these practices. To summarize, PE and PAS are more accepted than AE, and the most critical arguments in favor of these practices are the respect for autonomy and the relief of suffering. Personal beliefs and the social role of the physician as a healer are the most common arguments against these practices. Even though a consensus may not be reached easily or soon, continuing the discussion about end-of-life decisions is essential because the debates over these practices and the necessity for such decisions will unavoidably linger. Medical students must be aware of different perspectives on the topic to make an informed decision in related circumstances.

Citation to this article:

Gutierrez-Castillo A, Gutierrez-Castillo J, Guadarrama-Conzuelo F, Jimenez-Ruiz A, Ruiz-Sandoval JL. Euthanasia and physician-assisted suicide: a systematic review of medical students’ attitudes in the last 10 years. J Med Ethics Hist Med. 2020; 13: 22

Conflict of Interests

The authors declare that they have no conflict of interests.

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